From the author.
During my career as an educator, I always used to repeat to my students: ”we are teaching you the science-based massage therapy. You will be trained how to perform massage techniques, appropriate sequences of massage techniques specifically designed for different massage protocols. We will teach you scientific concepts, including the physiological effect of massage on the human body, pathophysiology of disorders that you will treat, and the skill to control the amount of pressure you should apply when addressing abnormalities. When it comes to learning, try to understand the material to the deepest level possible rather than just memorizing it. The only thing we cannot teach you is a sense of touch. The sense of touch is what makes a difference between a good and a great therapist. During training, we will do our best to help you develop a sense of touch.”
I always used to finish this type of a conversation by saying: ”Please remember that when it comes to the development of a sense of touch and your abilities to deliver results, the sky is the limit. This is an ongoing process. I spent many years in the field and yet I continue constantly developing and improving my personal sense of touch.”
Years ago, in the end of the class, two lady-friends from Inglewood CA used to joke with me:” Boris, you are so smart and experienced, and yet you cannot define what sense of touch is. The class started laughing, and joining them I said: ”It looks like I’m not smart enough to define what sense of touch is.” The class was dismissed, and little by little the students started walking out from the classroom. Suddenly from nowhere, I have asked the class to be seated and announced: “Guys, I have the definition of what sense of touch is. The sense of touch, is your ability to understand, the physiological effect of massage, pathophysiology, etc., to the point, that you will see with your hands, what eyes cannot see.”
I never in my life, wrote an article, like the one I’m offering you today. I strongly believe that if one to carefully study this article, it would help you to develop the sense of touch to even greater degree.
Best wishes and good luck
With technological developments of testing equipment, we are getting a more scientific explanation on what we are doing.
Those who have been massage therapy practitioner for a long time, sometimes witness clients’ emotional releases. Clients might cry, shake, demonstrate painless muscle constriction, complain about a sensation of cold with the room temperature of 75°. Some report crying after the treatment.
Usually, these releases happen when we apply kneading techniques on specific areas of the body. We call these areas “bookmarks” of emotional memories. These emotional memories are stored somewhere is in the brain.
While a student, I was told, that everyone, even the clients who are not crying out, releases this emotional garbage. When treating cases of anxieties, depressions, chronic pain, phantom pains, it is extremely important to clean up this emotional garbage, because when it’s stored somewhere in the brain at a subconscious level, it’s constantly poisoning well-being of patients, not allowing them to progress in a healing process.
Today, Melzlack‘s neuromatrix theory of pain and anxiety explains much more about the phenomenon of central sensitization of pain, emotions, etc. When we spend 50% of a procedure time on kneading, the human body reacts to original stimuli with multiple positive changes in functions of organs and systems. Therefore, during numerous repeated treatments, we achieve an approximate balance of sympathetic and parasympathetic activities. Please read a short explanation of the physiological effect of massage on the human body.
As far as I know, back in the nineteen seventies, our professors, MDs, and PhDs used to teach us that unless emotional garbage will be cleaned, it would be practically impossible to get to the desired balance of autonomic activities. This blog is a clarification of what Bookmarks are. I was told, it became clear from treatment room experiences that by creating an action potential, somehow, from the areas of somatic bookmarks, we stimulate and awaken reactions – emotional releases. No one even suspected, that nociceptors would be triggered, and stimulate emotional release.
On a side note, I always have been amazed and admired writings of Dr.RossTurchaninov. Practically any piece of writing he created, is good enough to be used as a study material in schools. In this article, inspired by his narrative style, I will try to create simple “schooling” article on this subject.
Please try reading this article carefully (the link is below), paying a special attention at what I proposed in my article four years ago: “Nociception can also cause generalized autonomic responses before or without reaching consciousness to cause pallor, diaphoresis, tachycardia, hypertension, lightheadedness, nausea and fainting. as you can see it is a very complicated physiology and pathophysiology.
Let’s continue the lesson.
Please careful read, my blog below.
Now, please, read the article below. Actually, I have to thank James Westmoreland for it, who referred me to Eric Delton’s site, where he posted the link below.
I’m quoting from the article. “The reason we can say this stimulus is painful, it’s hurting me, is because there’s a signal from our arm reaching the spinal cord, and then from the spinal cord to the brain,” Colloca told Seeker.
Dear friends, please pay attention, nocebo triggered/activated/released pain impulse. This was recorded by fMRI scans. Of course, before this equipment was developed, we all, including myself, believed that nocebo is a purely psychological phenomenon/brain generated pain.
As you understood from my previous explanation, the central sensitization of pain, and the central generation of pain and anxieties, was known much before professor Melzack proposed NMT of pain and anxieties. This great neuroscientist only formulated this as a scientific theory.
Let’s discuss functions of nociceptors.
Peripheral receptors cannot generate pain, emotional responses, hot or cold sensation, etc., but can only generate impulses. Of course, when impulses reach the brain, the brain generates pain, hot or cold sensation, etc.
We shall ascertain that the intensity of pain that one experiences, depends proportionally on the intensity/ frequency of pain impulse. For example, if one will cut a finger superficially, pain receptors will generate a certain low-grade intensity/frequency pain impulse. When it reaches the brain, we do feel pain but not an intense one. When a finger cut is deep, causing a significant wound, the more significant amount of pain receptors would be involved, which will generate high-intensity/frequency pain impulses, and when they reache the brain, the brain generates high-intensity pain. This is a general principle.
Interestingly, researchers used a special equipment in this study that recorded nocebo triggered pain and pain were not generated in the brain unless the brain received pain impulse. Goodness! Is it conceivable that nocebo activates pain receptors/nociceptors to generate pain impulse? Personally, prior to this study, I would be convinced, that nocebo effect is a pure brain generated phenomena.
It is appropriate to make a following statement.
We know, that the brain can generate pain on its own. When it’s happening, why would the brain send any impulses to peripheral receptors, or even to spinal cord? Besides, in cases of phantom leg pain, there is no leg, therefore cannot be nociceptors.
On the other hand, these researchers obviously recorded nosebo/psychological factor activated nociceptors. As a matter of fact, in this case harmful logical stimuli haven’t been involved. Obviously, psychological factor triggered generation of pain by brain, and only then its impulse was released and activated nociceptors. There must be a reason for that and, I suspect, that this reason is making people instinctively massage a painful spot, release action potentials, to stimulate centers. Later I will provide a more extended explanation on what I have said above.
Now let’s come back to what I have published four years ago.
“Nociception can also cause generalized autonomic responses before or without reaching consciousness to cause pallor, diaphoresis, tachycardia, hypertension, lightheadedness, nausea and fainting.
Was it pure psychological, brain generated phenomena? I doubted it.
It has been recorded that nocebo activates pain receptors/nociceptors, which in turn generating pain impulse.
These findings, just add an additional support to a scientific explanation for what we do as massage therapists.
There is no doubt in my mind that bookmarks containing nociceptors, encoded to stimulate centers containing emotional memories. When massage stimulates nociceptors, they release action potentials/specifically encoded impulses, which trigger the release of traumatic memories, stimulate centers in the brain, and promote emotional releases.
Can this nociceptor carry any memory? Of course not. These bookmarks connected to these emotional memories in the brain, and when we mobilize skin, fascia, and muscles, we release action potentials within mechanoreceptors, including nociceptors. Massage of these bookmarked areas generates a huge amount of therapeutic impulses, flow of therapeutic action potentials, and this is what stimulates emotional releases, as well as other multiple positive changes in functions of organs and systems.
Massage of emotional memories’ bookmarks, seemingly prompts nociceptors to generate impulses of therapeutic frequencies and intensity. These action potentials, stimulate access to emotional memory in the brain and trigger release of damaging to well-being emotions.
Let’s refer to the physiological effect of massage, which was researched by Dr.Sirazini in 1937 and is accepted and clinically proved today as the scientific fact. Action potentials released from mechanoreceptors stimulate central nervous system and trigger multiple positive changes in functions of organs and systems. What I didn’t know until this study came out, is that nocebo, supposedly purely psychological factor, also triggers pain receptors/nociceptors, releasing pain impulse. Thus, the current state of my understanding, is that emotional releases that we trigger because of massage, is a result of action potentials released from nociceptors.
What I knew, was that we cannot release nociceptive action potentials, until painful stimuli are applied to a patient’s body. It could be caused by either vigorous pressure, or tissue injury, or hot or cold sensation that would come to contact with the body, including the hot or cold environment. Now I am positive that by providing massage we can release action potentials within nociceptors, without harmful stimuli etc.
One might wonder, why this is such a big deal? Do we witness the phenomena of emotional releases for many decades? I would agree with this comment, because from a clinical perspective, for most of us, the important evidence is an evidence of results. Still, in my opinion, for us, this is an important discovery.
In a frame of established facts of medical physiology, we can speculate on processes, which are not yet established by scientific experiments. Especially if these speculations, are supported by clinical outcomes.
For example, in the aforementioned study, using a special equipment researchers recorded nocebo effect triggered pain; pain that wasn’t generated by the brain without receiving pain impulse.
Why would it be wrong to conclude that nociception can also cause generalized autonomic responses before or without reaching consciousness? Thus, pallor, diaphoresis, tachycardia, hypertension, lightheadedness, nausea and fainting are the result of nociceptive impulse, which reaches emotional storages and causes a negative unpleasant clinical reaction.
Why cannot we conclude, that by performing kneading techniques, paced as 70 movements per minutes, we generate a massive release of therapeutic action potentials, including those from nociceptors? Then, by reaching emotional storages, we trigger therapeutic effect of emotional releases.
Quantity, quality, and the intensity of stimulation equals reaction. Nociception generates a sympathetic reaction. A short time, aggressive nociceptive impulses, cause diaphoresis, tachycardia, hypertension, lightheadedness, nausea, and fainting. Therefore, while creating a massive therapeutic release of nociceptive action potentials, we, in fact, treat mentioned above disorders. We know that massage therapy is a very powerful methodology of treatment, in cases of diaphoresis, tachycardia, hypertension, lightheadedness, and nausea. This is a clinical effect. Why cannot we conclude, that in addition to reporting pain, nociceptors, hot and cold sensation can trigger sympathetic reaction/panic attack, at the time when we engaging them, deforming nociceptors, reaching the level of adaptation, therefore successfully treating anxieties?
I will try to reach out to patients who suffer from hypochondria, and I think massage therapy will work. The importance of this conclusions I’m discussing in my summary below.
The great Neuromatrix theory of pain and anxieties, astonishing recording by fMRI scans: ”nocebo triggered/activated/released pain impulse”… did it change the way we practice massage? Not really, not the way we perform hands-on protocols. It just offers us an additional explanation, understanding, and a scientific support – adds validity to what we do. In my opinion, these findings, make our hands-on performances, better and more meaningful. It is boosting our therapists’ energetic status. Our occupation is unique as we use our hands during treatment, which makes the energetic connections much stronger than those spun by any other healthcare profession.
Now, for a better understanding of what I said above, I would like to offer you some extra curriculum LOL work. Read this article.
Please let me know if my article was a good study material. Also, as you understood, my narrative regarding the relation between centers, nociceptors within bookmarks, release of nociceptive action potential due to massage stimulation is my own conjecture.
If you will be able to find a disconnect in my presentation, please do not hesitate to post a rebuttal. It’s important for me, as it’s important for each of us if we are to advance. Looking forward to good discussion.